EC Clinical and Medical Case Reports

Background: Vaginal gangrene is extremely rare in pediatric patients, especially adolescent females. Chemotherapy-induced immunosuppression increases susceptibility. We report a case of vaginal gangrene in a 15-year-old girl with acute myeloid leukemia (AML), with MRI characterization of fistulous tracts and abscesses, and response to hyperbaric oxygen therapy (HBOT).

Case Presentation: A 15-year-old female under induction chemotherapy for AML (monosomy 7) presented with 10 days of bilateral labial swelling and necrosis of the left labia majora. Pelvic MRI showed a 54 mm blind-ending fistulous tract in the left labia with abscess collections (largest 15 × 6 × 14 mm), and extensive fat infiltration reaching the proximal thigh. She was treated with broad-spectrum antibiotics and HBOT, without initial surgical debridement.

Conclusion: Vaginal gangrene in adolescents is rare but life-threatening, particularly in immunocompromised patients. MRI enables early diagnosis and therapeutic planning. HBOT can be considered as a non-invasive adjunct in selected pediatric cases.

Keywords: AML; Vaginal Gangrene; Pediatric; Hyperbaric Oxygen Therapy; MRI; Fistula; Fournier’s Gangrene

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